Another doctor has tested positive to Lassa fever at the Lagos University Teaching Hospital, Idi-Araba.

The Chief Medical Director, Prof. Chris Bode, who confirmed the new case on Friday, said the doctor had had contact with the index patient.

Three doctors who attended to the first patient, a 32-year-old pregnant woman who eventually died, had tested positive to the disease; while 135 other contacts were placed under surveillance at the hospital earlier this month.

LUTH had discharged the doctors who had been infected with the disease on Wednesday after they were certified free of it by experts at the tertiary hospital.

Bode, in a statement on Friday, said the doctor tested positive to Lassa fever on Thursday.

Bode stated, “The three doctors admitted with confirmed Lassa fever have all been certified fit and discharged home because subsequent repeated tests on them showed they have now tested negative.

“The 70 of the contacts being followed up have also been let off, having completed their period of observation.

“However, one new case was identified yesterday (Thursday) from among the doctors that first had close contact with the index case and she (the doctor) has already commenced treatment and is expected to recover fully very soon.

“Psychological and other supports have also been provided and her family contacts are closely monitored.”

The CMD who said the Federal Ministry of Health and the Lagos State Ministry of Health had provided more drugs, Personal Protective Equipment, follow-up services and decontamination services added that over 400 LUTH staff had been trained on the protocols of identifying and managing haemorrhagic fever to ensure that cases are caught early at the tertiary hospital.

“Overall, the disease is gradually tapering off, but we must remain vigilant while ongoing efforts are maintained to control the disease.

“There is a fully equipped response squad available round the clock to assess and take over the management of any suspected case in LUTH,” Bode added.

A strange disease, whose symptoms include diarrhea, blood-stained vomiting, and high fever has killed 50 people at Okunran, Okoloke and Isanlu-Esa villages in Yagba West Local Government of Kogi.

Initial reports had suspected Lassa Fever, but medics told Dr. Saka Audu, Commissioner for Health, who visited the affected areas on Thursday, that it was a strange disease that was unknown.

“We initially suspected Lassa Fever after getting some misleading reports about people bleeding around, so we made a diagnosis of viral hemorrhagic fever (Lassa fever), but the result was negative,” Dr. Jannette Hathorn, a Consultant at ECWA Hospital, Egbe told Audu.

She said that the first case was that of a child of two and half years, who died 12 hours after he was brought to the hospital.

“We are sure it is not Lassa fever, but our concern is that we do not know exactly what is happening. We have not arrived at a definitive diagnosis.

“Two adult patients were also brought here; one showed symptoms of viral illness, but there was no bleeding component or any hemorrhagic symptom.

“We isolated them and both of them were treated for malaria. When they started improving, we let them go.

“Another parent brought a child to the hospital and pleaded for help. He said that 50 people had died in their village with similar symptoms of blood stained vomiting, diarrhea and fever.

“When the child died, we called the World Health Organisation Yesterday (Wednesday), their officials came and took samples of everything; we must know exactly what we are dealing with,” she said.

Audu, who described the situation as “serious”, said that the visit was to assess the it “especially since many lives have been lost to the disease”.

“We want to determine the cause of these mysterious deaths and then proffer solution to it.

“Government is committed to assisting the people irrespective of how remote their settlements may be. We must ensure that we take healthcare to the door steps of rural dwellers.

“We want to reassure the people that government is with them and will take full responsibility of those who are already ill, so as to arrest the spread of this disease.

“For now, what is clear and confirmed is that it is not Lassa fever; but whatever it is, we will carry out further investigation and come up with a definitive diagnosis,” Audu said.

He said that the information about the outbreak of the strange disease came to the government last week and a technical team was immediately sent to take samples which were sent to General Hospital Irrua, Edo State, for definitive investigation.

“We are digging into the real cause of this ailment. All hands are on deck toward unraveling the definitive cause of the mysterious deaths among the kids,” the commissioner assured.

According to him, the Fulani settlers have been reported to be the worst hit by the disease which broke out three weeks ago.

The Minister of Education, Adamu Adamu, on Wednesday, admitted that the Federal Government indeed failed to meet its part of the agreement reached with the Academic Staff Union of Universities last year which led to the ongoing industrial action declared by the union.

However, he said the government was not happy that ASUU embarked on the strike without following due process by giving adequate notice.

Adamu spoke with State House correspondents after the weekly meeting of the Federal Executive Council presided over by the Acting President, Yemi Osinbajo, at the Presidential Villa, Abuja.

The minister said the government had realised that it made some promises to the union which it has yet to fulfill.

He said he would be meeting with leaders of the union on Wednesday evening or on Thursday.

He expressed optimism that some agreements would be reached at the meeting and the strike would be called off as soon as possible.

The minister said, “It is very sad that I am here and ASUU is on strike. Late last year, we had a meeting because ASUU gave one week notice of strike and we were able to work out some agreement.

“I must confess that government has not fulfilled its part of the bargain. Though we are unhappy that ASUU went on this strike without following due process and giving us good notice, we realised that we promised something and we didn’t fulfill it.

“I hope I will be meeting them later today (Wednesday) or tomorrow (Thursday) and I am sure we will be able to reach some agreement so that the strike will be called off as soon as possible.

“I am sure you are aware of the issues we agreed on. There is the issue of re-negotiation which is the only one they agreed government has done what it promised because we set up the re-negotiation team and negotiation is already ongoing.

“There is the issue of Earned Allowances and I think because of some miscommunications, what we promised could not be done, but am I assuring ASUU and the whole nation that this is going to be done.

“There is the issue of registration for Nigerian Universities Pension Commission. I think on that one, there are a few issues that need to be sorted out with the Nigerian Pension Commission. I believe there will be no problem with that.

“On the issue of their staff school, I think the court has given them verdict to go ahead with it. They have requested that they should be allowed to stay off TSA and I think the government will not do this.

“But there are some peculiar funds in the university like endowment which are monies kept and all the interest they generate, prices and so on are given.

“Government will exempt that one only. But universities are part of the peculiarities. They just must log on. I hope later on when I meet them today, there will betotalagreement.”

The Federal Government has approved the sum of N44 billion for payment of backlog of promotion arrears, salary shortfalls and other staff claims owed to public servants since 2012.

Head of Civil Service of the Federation, Mrs Winifred Oyo-Ita, made this known during an interactive session with civil servants at the Public Service Institute, Kubwa, Abuja as part of activities marking the 2017 Federal Civil Service Week.

She explained that the Federal Executive Council (FEC) had already approved the marshal plan by the Federal Ministry of Finance on how to settle the staff outstanding claims and arrears.

Oyo-Ita, noted that while the sum of N30 billion was set aside for the payment of outstanding promotion arrears owed workers since 2012, the government earmarked additional N14 billion for payment of salary shortfall for affected Ministries, Departments and Agencies ( MDAs).

She also pledged to ensure digitisation of the full content of the public service operations in order to make for more efficiency and transparency in the service delivery to the nation.

She said: “Records revealed that the outstanding claims and arrears owed public servants had accumulated as far back as 2012 during which period the nation was in funding surplus but the allowances could not be paid.”

“However, in the past couple of months, we have had series of engagement with the Presidency, the National Assembly and relevant MDAs for the payment of our outstanding promotion arrears and other entitlement.”

“These engagement have culminated to the commencement of the payment of outstanding promotion areas in tranches.”

“The Office of the Accountant General of the Federation under directive has issued a Circular for MDAs to individually submit their accumulated promotion arrears which will be credited directly to your accounts.”

“In the same vein, His Excellency, the Ag. President has equally directed the Budget Office of the Federation and the Federal Ministry of Finance to put in place modalities for the settlement of our other outstanding allowances, this is in top gear and a Circular would be issued in due course to intimate us on the payment plans.”

“Again, in line with this Administrations drive on accountability, each beneficiary will have their payment credited directly to his/her account.”

“It is pertinent at this juncture that I acknowledge the effort of the various Unions towards the amicable resolution of this matter and pray for continued cordial relationships as partners in progress,” she said.

While urging workers to reciprocate the gesture of the current of President Muhammadu Buhari and the Acting President, Professor Yemi Osinbajo, SAN, who have shown great commitment to the welfare of workers, the Head of Service said civil servants could no longer continue to conduct government business in the manner which has brought the Civil Service much disrepute.

She insisted that workers must individually and collectively as “efficient, productive, incorruptible and citizen-centred public servants embrace this change for us, our children and generations unborn”.

“We have to rededicate ourselves to the aspirations of the current administration to achieve a national economy that we shall all be proud of. But I want to assure you, that the Federal Government is working assiduously to ensure the betterment of our work environment and service conditions,” she said.

Nigeria’s Minister of Health, Isaac Adewole, has decried the paucity of doctors in the country to render high level of medical services to Nigerians, saying something urgent has to be done to address the situation.

This submission by the Minister according to some medical experts “is certainly why many Nigerians including President Buhari go abroad for medical treatment, if the country has adequate personnel with up to date facilities, our president and other Nigerians will not go abroad for treatment”.

However the Minister who was silent on the issue of medical tourism during Cross River State’s organised health summit, with the theme, ‘Translating Health Policies and Plans into Action” recently, said because of the inadequate doctors, the President Buhari led federal government must see that medical services in the country improves.

He said the federal government was poised to establish Primary Health Centres in all local government areas of the country as foundation for healthcare provision, but that there are limited number of doctors to go round the whole country.

Adewole who described the summit as trail blazing and lauded Gov Ayade and his team for exhibiting political will in tackling challenges in the health sector, particularly with restoration of accreditation for School of Nursing in the state, stated that “developing the state strategic plans and translating it into action will require enormous political will and commitment. We must cultivate and sustain partnership with development partners.”

In his remarks, Ayade said his administration was on a “rescue mission to revamp and revitalise the economy” and that the AyadeCare Health scheme guarantees easy and cheap access to quality healthcare in the state.

No amount of excuses can justify misdiagnosis, increasingly a cause of several deaths in Nigerian hospitals. Instead of passing the buck, following strictly the ethics of the profession may be a surer way out.

During one of the sessions of her driving classes, Mandy Dikibo noticed tremors in her legs while pressing the clutch in the manual car used for the training. Prior to that time, she noticed she had difficulty stooping, climbing steep places, intolerance of heat coupled with heart palpitations and fast pulse rate.

With these symptoms, Dikibo went to one of the renowned hospitals under her Health Maintenance Organisation (HMO) located in the highbrow Ikoyi neighbourhood in Lagos.

After narrating all the symptoms to the doctor, she was told that everything she noticed was normal, especially since they were obvious after carrying out some activities.

Four months later, Dikibo was rushed from the office to the hospital, a different one this time because her office had changed its HMO. On getting to the hospital and narrating the symptoms, she was given a prognosis of hyperthyroidism pending further examinations she was asked to undergo.

When the results came out, they confirmed the prognosis for a disease in which treatment would have started four months earlier. The doctor was even kind enough to apologise for the misdiagnosis from his colleague in the first hospital. A year and four months later, Mandy is still undergoing treatment. Perhaps an early and accurate diagnosis would have arrested the disease.

Most times people do not think much about the problem of misdiagnosis and its far-reaching consequences unless when such leads to death. Sad to say, there have been several deaths and most times complications arising from misdiagnosis, the latest of which is the death of Kolawole Idowu, a 29-year-old who had just completed the mandatory one year National Youth Service.

According to reports, Idowu took ill just after his service and had gone to the Ikeja Medical Centre, a private hospital in his neighbourhood, where he was treated for malaria and after a negative reaction, he was admitted for mental illness.

After spending about two weeks at the hospital, Idowu was transferred to the Lagos State University Teaching Hospital, LASUTH, Ikeja, where he was placed on admission at the psychiatric ward. He later went into coma and was taken to the Intensive Care Unit of LASUTH. After about two months in the ICU, he passed on. The autopsy report said Idowu had an infection called meningoencephalitis and later, bronchopneumoni, which “continued till death”.

How Idowu’s case moved from “ordinary” malaria to mental illness to an infection called meningoencephalitis, and then to bronchopneumonia continues to baffle many.

A worrying trend

Idowu is just one out of many cases of misdiagnosis recorded in Nigeria, and as is often the case, deaths arising from situations like this are brushed aside as seeking redress seems farfetched.

“Clinical negligence and medical errors is rife in most developing countries such as Nigeria because of chain reactions of events viz: cultural notion regarding adverse medical events; poverty and financial ineptitude to pursue legal action against perceived negligence; ignorance of the rights of the individual to seek redress in court in the face of gross clinical negligence and serious harm; indifferent attitude of health-care providers toward their patients’ well-being; limited options of treatment; and poor health-care delivery system,” said Felix Nzube Chukwuneke, senior lecturer, Department of Maxillofacial Surgery, College of Medicine, University of Nigeria, Nsukka.

“It is also important to note that clinicians and health-care providers in Nigeria and elsewhere are not infallible and a lot have been doing their job diligently in keeping the good reputation of the health-care profession,” Chukwuneke said in a paper, ‘Medical incidents in developing countries: A few case studies from Nigeria’.

According to him, the moral worth of a clinician’s action in patients’ management depends exclusively on the moral acceptability of the rule of obligation to duty on which the clinician acts.

“Since every rational being thinks of him or herself as an end, all people must act in such a way that they treat humanity, whether in their own person or in the person of another, always as an end and never simply as a means. A duty of care is, therefore, paramount in the relationship between clinician and patient. While litigation in healthcare system is rapidly increasing globally, which affords individual explanation and compensation for perceived wrong diagnosis and treatment, it is still rudimentary in Nigeria. This default position has made most health-care providers indifferent in the presence of gross clinical negligence and medical errors,” he said.

“Though most Nigerians may be aware of their rights to institute legal action in situations such as negligence with serious harm or death, the socioeconomic factors, cultural and religious notions among other reasons within the society often make litigation impossible for an individual. Attributing every medical adverse event in the course of treatment as ‘God’s Will’ and the saying ‘It’s God’s Time’ for every death among most African people has also become a great impediment to curbing clinical negligence in our environment,” he added.

Chimaobi Udenze, a gynaecologist, is of the view the misdiagnosis issue is a sad one because it queries the competence of medical professionals and withdraws patients’ confidence on even the so-called consultants.

“Imagine giving a neighbour’s child wrong prescription and he dies days later. Many will refer to the doctor as quack, and how would he live peacefully in that same compound with such neighbours or even raise his shoulders high when they call doctors? As journalists are conscious of their byline, so also should a doctor because name is everything in medical profession,” he said.

Passing the buck

At its National Executive Council meeting held in Calabar, Cross River State, recently, the National Association of Resident Doctors (NARD) lamented that the Federal Government was frustrating resident doctors due to lack of training, alleging that the government’s insincerity has often forced resident doctors to seem indifferent to patients’ conditions.

John Onyebueze, national president of NARD, said the perceived ‘indifferent’ behaviour by the resident doctors has been a result of repeated cases of insincerity by the various government agencies.

“Over the years, there has been incessant disharmony in the health sector owing to the inability of various government agencies to abide by agreements reached or obey extant circulars. A case in mind is the July 14, 2016 stakeholders’ meeting chaired by Hon. Yakubu Dogara,” said Onyebueze, who spoke on the theme ‘Funding postgraduate medical education – a panacea to medical tourism’.

He maintained that funding postgraduate medical education in the country would ensure that the current brain drain in the profession is stemmed, while the number of those going for medical tourism abroad would reduce to the barest minimum.

Onyebueze lamented that resident doctors were made to work under very unfavourable conditions, thus adding to their frustration which, according to him, is transferred to the patient.

Excuses are not enough

But Onari Duke, wife of former Cross River State governor and chairperson at the event, challenged doctors to rise above the current challenge and work out solutions to their persistent problems with the authorities.

She urged the resident doctors to come up with a practical programme of action that would enhance their welfare and professionalism, saying the country had suffered enough through persistent strike actions.

Udenze said no excuse could justify misdiagnosis and negligence by doctors.

“My colleagues are quick at blaming government for not providing world-class medical facilities as well as an environment conducive for them to profitably ply their craft here, but if one follows the ethics of the profession, there will not be cases of misdiagnosis,” Udenze said.

“Of course, do not conclude until you are sure of the final result. If possible conduct the test again or consult your senior colleagues on intricate issues. You can check referrals on such cases and compare results and trends. At the end, you will end up doing everything that is medically possible to save life and if death comes, then it is the patient’s fate,” he said.

Any way out?

Chukwuneke proposes that health-care stakeholders and policymakers should put in place legal and legislative measures to curb this menace while clinicians, for the sake of obligation, should ensure that they maintain the highest standard of patients’ care in their practice.

“There is a need to emphasize early medical ethics training for health-care professional at the undergraduate level as well as promoting and organizing workshops to constantly keep them well-informed,” he said.

“The public from time to time should be encouraged to report any case of suspected negligence and medical errors in order to have documented evidence on the rate of occurrence. This in turn will help the health policymakers and medical regulatory body (NMDC) to understand the extent of the health problem and find out the best method to reduce the rate of occurrence in the health-care sector,” he said.

For Udenze, however, change should start from the entry level.

“You cannot gain admission to study medicine on compassionate ground or lower cut-off point. With the disparity in entry requirements occasioned by quota system, Nigeria has graduated different levels of medical doctors, many of whom saw graduation as a must. You must not be a doctor because your father or mother is a doctor and needs you to take over his/her hospital. That is why the issue is escalating,” said Udenze.

“I think medical students should have separate hostel arrangement. Update of medical facilities should be taken seriously and monitored to ensure funds are not diverted to personal use. EFCC has not beamed its searchlight on government hospitals, they should because the chief medical officers, procurement and finance managers need to tell Nigerians where all the allocations captured in the Federal budget for health go,” he said.

He also suggested that registration of private hospitals be stopped for now until existing ones improve on facilities and remuneration of doctors because younger doctors do not see the goldmine their colleagues saw in the 70s and 80s now.

“There should strict rules and compliance for registration and renewal of licence,” he said.

Brain drain in the health sector

Meanwhile, citing poor working environment, Nigerian medical doctors are trooping out in their numbers in search of better work opportunities abroad.

Ben Murray-Bruce, senator representing Bayelsa East and founder, Silverbird Group, took to one of his twitter handles to lament the brain drain facing the health sector in the country.

According to him, “700 Nigerian doctors relocate abroad annually because we prefer spending $1bn on medical tourism than spending it on our health sector.”

As expected, there were many rejoinders to his comment. Some challenged the senator to reveal where he does his annual medical check-up, while others asked him to propose a bill criminalising medical tourism and banning public officers from seeking treatment abroad.

One respondent said, “As a doctor, I cannot argue with the statement, but the healthcare system needs a full overhaul and political will and you can help.”

“Sir, unless a law is passed that stops lawmakers from travelling abroad for medical check-up, all this won’t solve anything,” another retorted.

Another respondent registered his disappointment and displeasure saying, “Unfortunately Buhari has disappointed Nigerians. He promised an improved medicare, but he’s the first to travel abroad for treatment.”

Some others pointed out that the figure mentioned by the senator was an understatement, stating that the number was in the thousands. To all these comments and retorts, the senator made no remarks to take up the challenge of bill proposition.

While discussing survey findings during a panel session with stakeholders on its recent poll on ‘Emigration of Nigerian Medical Doctors’, NOIPolls said almost 9 in 10 doctors interviewed disclosed they are currently seeking work opportunities abroad.

According to the polls carried out in partnership with Nigeria Health Watch, of 88 percent doctors who said they were considering work opportunities abroad, 91 percent are at junior level, followed by 8 percent who are mid-level, and 73 percent are senior level medical practitioners. Top locations for Nigerian doctors seeking work opportunities abroad include United Kingdom 93 percent, United States 86 percent, Canada 60 percent, Saudi Arabia 59 percent, Australia 52 percent, and UAE 29 percent.

Several doctors complained of relatively poor working environment, which implies lack of adequate equipment, infrastructure, and medical supplies.

Measures recommended to stem the tide on the emigration of doctors from Nigeria include better salaries 25 percent, more funding in health sector 24 percent, better working environment 11 percent, and provide career development plan 9 percent.

The pll harped on the need for the government at federal and state level to focus on upgrading tertiary health facilities, adding, “There is need for the right people to head the health sector, so Nigerians can access proper medical care.”

“Between now and September 2,500 doctors will be leaving the country for better opportunities because it has been a trend. It is imperative to improve and invest in the health sector. What happens to the sector if all trained doctors emigrate?” said Bell Ihua, CEO, NOIPolls.

“Globally, there is a call for universal health coverage, providing the needed health finance for a conducive working environment for medical doctors translating to more remuneration, and increased training opportunities,” Ihua said.

Akeem Lawal, chemical pathologist at National Hospital Abuja, is of the opinion that government should ensure an enabling environment, particularly in terms of structures/facilities in the health sector.

Abimbola Olajide, general surgeon, Ladoke Akintola University Teaching Hospital, agrees, urging the Nigerian government to look inward and ensure a change in the health sector.

Our indefinite withdrawal of services enters day 6 today. This action was after exhausting all means of dialogue with several ultimata shifted for the sake of our patients , populace and for the good of the hospital.

Sad to note is the fact that the state government has continued to pend the reversal of this illegal and inconsiderate action of percentage salary payment which is 28% of what is expected. The attendant jeopardy to the future of all with impaired quality of life alongside direct and indirect loss of life is unimaginable.

Equipment delivery and infrastructural development have remained relatively same since the last one year despite promise by the stakeholders to wade in for palpable solutions.

Demoralising is the fact that the daily geometrical proportion of exit of consultants and residents seem not to bother the powers that be, rather the excuse of no funds for employment of more residents has now been parried aside for casualisation of this noble Hippocratic profession. THIS IS UNACCEPTABLE AND WILL BE RESISTED.

It appears to us there is some form of deceit in some quarters.

We demand as follows:

1. Full sponsorship for all training, revision courses, update courses, supranumerary postings, research grants, research and methodology, management courses be effected in full by the management without further delay.

2. That the state of the art equipment yet to the delivered should be delivered and installed while the ones delivered be put to use.

3. Infrastructure be completed in the hospital without further delay.

4. The massive brain drain in the hospital be stopped by immediate improvement in the working conditions, appropriate remuneration of our members as well as employment of sufficient staff to keep the hospital at the best position for delivery of the zenith of all health care.

5. We demand an immediate reversal of the salary of our members in LAUTECH Teaching Hospital Ogbomoso to what is obtainable in federal teaching hospitals as is stipulated in the edict of the hospital not the demeaning and paltry 28% percent presently being paid since January 2016 salary. WE ARE BEING OWED OVER ELEVEN MONTHS SALARY.

6. A proper board of management be constituted for the hospital, not the statutory membership as is being run now.

7. Immediate stoppage of all attempts by management of the hospital to casualise Doctors. We state unequivocally that the Association of Resident Doctors LAUTECH Teaching Ogbomoso will resist this vehemently. This is unacceptable to this noble profession. The Nigerian Medical Association (NMA) has for the umpteenth time warned against this.

We reiterate that LAUTECH TEACHING HOSPITAL CAN NOT BE RUN ON ANYTHING SHORT OF FULL SUBVENTIONS AND FUNDS ALONGSIDE UNFLINCHING POLITICAL WILL FROM THE OYO STATE GOVERNMENT.

We are resolute on our demands and we shall continue in this withdrawal of services until all our demands are met so that the health of our members and the people of Oyo state can be safeguarded.

Gunmen stormed St. Philips Catholic Church, Ozubulu in Ekwusigo Local Government Area of Anambra in the early hours of Sunday.

According to an eyewitness report, the gunmen went into the church during the 5:45 am Mass and identified a particular man and shot him.

He said that the gunmen later went on rampage and shot at the remaining worshippers numbering over 100.

Scores of people were killed in the church while other critically injured worshippers died on the way to the Nnamdi Azikiwe Teaching Hospital, Nnewi.

The source, however, said the priest of the church was not wounded in the incident.

The Commissioner of Police in the state, Mr Garba Umar, confirmed the incidence, stating that the gunman killed eight worshippers and injured 18 others in the early morning attack.

Umar said the remains of the dead had been deposited at Nnamdi Azikwe University Teaching Hospital Nnewi. He also said the injured were taken to the hospital.

He said that preliminary investigations by the police revealed that the attack was carried out by a native of the area.

“From our findings, it is very clear that the person who carried the attack must be an indigene of the area.

“We gathered that worshippers for 6 o’clock Sunday mass at St. Philip Ozobulu were in the service when a gunman dressed in black attire covering his face with a cap entered the church and moved straight to a particular direction and opened fire.

“The man after shooting at his targeted victims still went on a shooting spree, killing and wounding other worshippers,’’ he said.

The commissioner said information available to police showed that the attacker was speaking undiluted Igbo Language at the time he was firing at worshippers.

Umar said though no arrest had been made, the police already learnt that the attack followed a quarrel between two natives of Ozubulu residing overseas.

Describing the act as sacrilegious, the commissioner of police said it was wrong for the perpetrators of the act to extend their quarrel into the church.

He added, “Such conduct shows the people behind the act do not fear God.’’

He said the police had launched a manhunt on those behind the act and gave an assurance that everybody behind the unfortunate incident would be brought to justice.

Umar described any insinuation that the attack was carried out by Boko Haram elements as false and urged the people to go about their normal businesses.

A Consultant Psychiatrist, Dr Adeyemi Egbeola, on Saturday in Lokoja, decried the increasing rate of recession-associated clinical depression in Nigeria.

Egbeola, who works at the Federal Medical Centre (FMC), Lokoja, made the assertion at the 2017 Annual General Meeting (AGM)/Scientific Conference Week of the Nigeria Medical Association (NMA), Kogi chapter.

The theme of the conference is: “Economic Recession and The Rise of Depression”.

According to him, a significant association has been demonstrated between macroeconomic indicators in recession and clinical depression as a mental illness.

“For every suicide committed, there is an average of 20 attempts (ratio 1:20), due to unemployment, self-rated mental health, debts, financial difficulties and other common mental health issues.

“Depressive disorder accounts for 80 per cent suicide, and hopelessness is the most predictive indicator of suicide, a depressive thought pattern.

“In 2015 from January to November, record shows that 25, 267 patients were treated on mental health at the Federal Neuro-Psychiatric Hospital, Yaba Lagos, while the number increased to 53,287 in 2016 within the same period.

“At the University of Ilorin Teaching Hospital (UITH), Ilorin, at the Adult Out-Patient Department (OPD), 3,500 patients were treated in 2015, while the number rose to 4,311 patients within the same period in 2016,” Egbeola said.

He urged the Federal Government to intensify training and supervision of low level manpower at the Primary Healthcare Centre (PHC).

The consultant psychiatrist said that government should also provide cheap, but effective medications and use of routine screening instruments to facilitate detection and reaction.

He also called for strengthening protective factors and mitigation of stressor, promotion of healthy lifestyle, adequate sleep, exercise, nourishing diet, and avoidance of smoking as well as moderate use of alcohol.

In his remarks, Gov. Yahaya Bello, commended the NMA for its support and commitment in delivering quality healthcare services to the people of the state, calling forbmore synergy and collaboration.

Bello said that the health sector had been one of the top most priorities of his administration, restating his commitment to use the available resources to better the lives of citizens.

He said that six ambulances were recently distributed to six local governments across the three senatorial districts of the state.

Bello, represented by his Chief of Staff, Mr Edward Onoja, said that recruitment of health workers are ongoing in the state.

The governor said that the state government had initiated a healthcare package tagged, “Bello Healthcare Plus” for women and children to be receiving free treatment and drugs across the 21 local government areas of the state.

Bello, however, urged the people to take advantage of various social intervention and agricultural programmes to improve their standards of living.

In his speech, the NMA Chairman, Kogi chapter, Dr Godwin Tijani, said that the meeting is part of the advocacy aimed at improving the healthcare services to the people of the state.

Tijani said that the theme of the 2017 AGM “Economic Recession and the Rise of Depression”, was carefully selected due to the current economic recession in the country.

According to him, the programme will enable them to examine the implication of economic recession and come up with suggestions on how to reduce the rise in depression in the society.

“It remains our firm goals and beliefs that Kogi NMA, partnering with the state government will turn around the poor health indices in the state, especially reducing maternal and perinatal mortality.

“We commend the sincere efforts and achievements of Gov. Yahaya Bello in the health sector since inception of his administration, and the cordial relationship NMA has been enjoying with the government.

“NMA also commends the singular act of reinstating and payment of salaries and arrears of our colleagues employed in 2015,” Tijani said.

He, however, appealed to the governor to look into the issues of eight of their members that are still on the uncleared list and many members that are still grossly underpaid.

Paris Saint-Germain have completed the signing of the century. For a fee of €222 million – far more than double Paul Pogba’s previous world record transfer of €105m – it cannot be considered anything but.

Neymar’s move to the Parc des Princes from Barcelona is the clearest statement of intent the Ligue 1 runners-up could have made that they have elevated themselves into a select group of superclubs who can win the Champions League each season.

That has been the obsession for owners QSI, who took over the club in 2011 but have failed to see their side progress past the quarter-final stages. When PSG infamously collapsed in the last 16 against Barca earlier this year despite being 4-0 ahead from the first leg, it seemed to epitomise the lack of winning spirit within their ranks, leading to core player Marco Verratti pushing for a transfer.

The Neymar deal is a stark admission of their unrelenting ambition, designed to not only improve their team, but to send out a message: PSG mean business.

Crowned the third-best player in the world at the 2015 Ballon d’Or awards and then fifth in 2016, the 25-year-old Brazilian offers the kind of guaranteed longevity that neither Cristiano Ronaldo at 32 nor Lionel Messi at 30, who have monopolised the prize since 2008, can.

PSG have seen at first hand the damage that the Brazilian can inflict on defences. As they crashed spectacularly out of the Champions League in March, it was Neymar who was the chief architect of the Catalan’s stunning 6-1 success, notably scoring twice late on before teeing up Sergi Roberto for the winner.

By the time they play their next match in the competition, though, they will be able to count the former Santos star among their own.

There is no debate about it; this transfer is an utterly defining moment not only in the history of PSG, but of world football.

Despite some initial scepticism in Europe when he arrived at Camp Nou showered in hype, he has built a reputation as one of the most exciting players on the planet. PSG already boasted one the finest midfields in Europe, and Neymar’s presence means they now have a forward line to match.

His arrival in Paris is on a completely different level to even the club luring Zlatan Ibrahimovic away from AC Milan in 2012. By that time the Swede was moving into the twilight of his career, on the brink of turning 31, and no-one could have predicted he would have quite so many stunning moments left in his career.

Ibra was a serial winner but came with the baggage of a poor Champions League record that he never entirely managed to shake. His heir arrives already with European club football’s greatest prize in his trophy cabinet.

Some might suggest the pressure of such an incredible transfer fee might weigh upon Ligue 1’s new superstar forward. That, however, has simply been day-to-day life for Neymar since he smashed his way onto the scene in his homeland.

During World Cup 2014, in particular, Neymar’s face was ubiquitous throughout his homeland, with seemingly every citizen of the football-crazy country pinning their hopes on the forward to lead them to glory. By the time Brazil were dumped out 7-1 by Germany at the semi-final stage, Neymar was nursing a fractured vertebra after being stretchered off a round earlier.

A decisive player so comfortable and capable of delivering on the big stage is something that PSG have previously lacked. Ibrahimovic failed at the crunch in Europe, Edinson Cavani remains somewhat enigmatic and Thiago Silva at the other end of the field is renowned as flaky.

Right-back Thomas Meunier has indicated that a winning mentality has been something PSG have previously lacked.

“It’s not yet in the culture of the club to think like it’s a giant, for the moment,” he said.

“If the club continues to grow like it has, guys won’t want to go to Barcelona but will instead want PSG.”

Indeed, the presence of Neymar will now attract further world class stars to the Parc des Princes.

His media presence, meanwhile, will shoot the club into another galaxy in terms of the worldwide coverage afforded to them. He is a dream from a commercial point of view.

Not all in France have welcomed the deal. Lyon president Jean-Michel Aulas, a notoriously shrewd mover in the transfer market, believes it will hurt his side.

“I don’t want anyone to say I’m against the arrival of great players like Neymar, who bring extreme visibility to Ligue 1 and have a positive effect on the value of the TV rights, but this increase in attractiveness will not compensate for the loss of revenues due to absence from the Champions League,” he argued to Journal du Dimanche.

“If PSG qualify due to their disproportionate financial advantage and Monaco claim the second qualifying place, the others are excluded from the system of generating the great incomes. It hurts those who work best.”

“According to the experts, Ligue 1 is a weak and uninspiring championship. It’s not bad to have attracted a player like Neymar to a league that is so uninteresting.”

Dijon goalkeeper Baptiste Reynet is another looking forward to pitting himself against such a superstar.

“Even if I’m a goalkeeper and at risk of him giving me all kinds of trouble, it’s great news for Ligue 1,” he tweeted.

PSG’s job, though, is to look after themselves. In signing Neymar, amid such fanfare and a mountain of controversy with regards to Financial Fair Play , they could not have bought a player more ideally suited to lifting them into the bracket of European superpower.

They have done it off the field, now over the next nine months they must show it on the pitch. Neymar, over to you!